Posted by Elizabeth on February 2, 2002, at 10:42:00
In reply to Re: Heart and anxiety » Elizabeth, posted by Lorraine on January 31, 2002, at 10:32:40
> Elizabeth, it's Lorraine.
'Ay!
> My pdoc took my pulse last week and told me I had tachycardia and referred me to a heart doctor to wear a halter. I went home and just did some blood pressure and pulse measurements of my own and what I found was that laying down my bp was 107/67 pulse 74, then standing still at three minutes 111/87 pulse 104 and standing still at 10 minutes 116/90 pulse 113--which to me sounds a bit like POTS (postual othostatic tachycardia syndrome).
What medication(s) are you on? I believe I had a similar thing going on when I was taking MAOIs (Nardil moreso, I think), and I didn't have any real problems with it. (My pulse ran about the same as yours in the three positions, although my BP was generally lower and I tended to have some OH.)
> My pdoc thinks that I may be randomly throwing out NE to generate the tachycardia--though I think there is a standing, sitting, laying, walking component to it as well. Have you ever heard of such a thing?
In general, your cardiovascular system will adjust to things like postural changes to maintain homeostasis; when the adjustment is limited and/or slowed, you get orthostatic hypotension. I imagine what's happening with you is similar.
> For a long time, two of my primary complaints have been fatigue and anxiety. Anyway, I did try a beta blocker sometime back (propanolol) which made things worse in terms of fatigue.
Hmm. Ever taken clonidine? It's an alpha-adrenergic autoreceptor agonist and is supposed to decrease HPA axis hyperactivity (in theory). If your pdoc's theory is right, clonidine might help.
There are also beta-blockers like atenolol that are cardioselective so they won't make you tired, hopefully. I think it'd be worth trying one if you haven't. They really are much less likely to have centrally-mediated side effects than nonselective beta-blockers like propranolol.
> It has all made me wonder, whether I have adequately "ruled out" physical problems that may be contributing (or causing or interfering with treatment success by causing side effects etc).
Well, you're going to see a cardiologist now. When's your appointment? Or have you gone already (and if so, what did the cdoc say?)?
> I have never had a thorough "work-up", neurological or otherwise. Though I have been told that I have some brain lesions and that my alpha waves are low. I'm thinking of getting a full neurological work-up, MRI of head and neck area and so forth. Do you have any thoughts you'd be will to share with me on this? I so value your input.
Hmm. You did get qEEGs done; I don't know much about qEEG but it might be worthwhile for you to see a neurologist based on the results if they're really abnormal. I'm not sure how it was concluded that you have brain lesions, but MRI would show that. My idea would be to ask your pdoc to refer you to a neurologist for a consultation to find out what tests you need, if any. The neurologist should get your records (such as the qEEG reports) as well as examine you.
I hope that this is helpful. I'm interested to learn what the cdoc has to say.
best,
-elizabeth
poster:Elizabeth
thread:91813
URL: http://www.dr-bob.org/babble/20020131/msgs/92598.html